Provider Demographics
NPI:1477721710
Name:BRIONES, AYDEE LEON
Entity Type:Individual
Prefix:
First Name:AYDEE
Middle Name:LEON
Last Name:BRIONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302-1559
Mailing Address - Country:US
Mailing Address - Phone:661-397-8775
Mailing Address - Fax:661-397-8286
Practice Address - Street 1:1305 BEAR MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:ARVIN
Practice Address - State:CA
Practice Address - Zip Code:93203-1231
Practice Address - Country:US
Practice Address - Phone:661-854-3131
Practice Address - Fax:661-854-2689
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CALCSW #756111041C0700X
CAASW #34241101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health